CMS recently released their 2023 final rule which includes two requirements that will have a significant impact on independent agents and brokers who sell Medicare Advantage and/or Part D plans.

Effective Date

While the marketing guideline changes are for calendar year 2023, they go into effect October 1, 2022, just before the start of the 2023 Annual Election Period for Medicare Advantage and Medicare Part D plans.

The Reason for These Changes

The ruling is thought to be in response to an onslaught of misleading TV commercials by Third Party Marketing Organizations (TPMO’s) and the subsequent increase of consumer complaints to CMS. With this final rule the definition of TPMO’s was expanded to include agents and brokers. It has been argued that consumer dissatisfaction is not usually with their agent of record but with TPMO call centers that solicit beneficiaries to switch plans that do not necessarily meet their needs. As of now, CMS has made no changes to the final rule so you should be preparing to be in compliance by October 1.

New Disclaimer Requirement

“We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact or 1-800-MEDICARE to get information on all your options.”

You will need to include this disclaimer in all the following places:

  • Verbally conveyed within the first minute of a sales phone call
  • Electronically conveyed when communicating with a beneficiary through email, online chat, or other electronic means of communication
  • Prominently displayed on your website
  • On all marketing materials, in print (12-point font) and television advertisements

For agents who offer all plans in their area, this regulation does not apply. But it is very rare for an agent to actually be able to offer all plans.

New Call Recording Requirement

Agents and brokers will need to record all sales calls with beneficiaries in their entirety including the enrollment process. The recordings must be retained in a HIPAA compliant manner for 10 years. This will apply to new and existing clients.

What is considered a sales call? Anything that falls under the “chain of enrollment’ which is defined as the events from the point when a beneficiary becomes aware of an MA/PDP plan to the end of the enrollment process. This means when you are calling leads, scheduling appointments, collecting drug and provider lists and conducting education meetings and phone enrollments. All of these calls would fall under this guidance. Medicare Supplements are not included in the new call recording rules however, if you are selling a Medicare Supplement in tandem with a Prescription Drug Plan, the call would need to be recorded due to the Part D discussion.

Zoom meetings will also need to be recorded. Only in person, face to face marketing and sales appointments are excluded, however any follow up calls to related to sales and completing the enrollment process would need to be recorded. Sales calls conducted on cell phones also fall under the recording guidelines.

We Will Help Ensure You Are Compliant

PTT Financial has the tools to help our agents be compliant. SimplyEnroll will have the functionality to record both the sales and enrollment process. You will have a dedicated recorded line for your clients to call. The functionality will be available to you when logged into the SimplyEnroll online dashboard.

Also available to our agents is Intulse, our VoIP phone provider that will allow you to record calls on your cell phone and give you the ability to link multiple lines. The cost for Intulse depends on your agency size. We have negotiated for our agents to receive a 50% discount on sign up fees and up to a 20% discount on recurring extension fees.

Both SimplyEnroll and Intulse have HIPAA compliant requirements and protections for recording calls.

PTT Financial continues to monitor the situation and will provide additional information and clarity as it becomes available, to help you comply with the new requirements.

PTT Agents should plan to attend our AEP Pre-Summit meeting on July 15 for more information on CMS Call Recordings, Intulse and SimplyEnroll 2023 training and enhancements.